| Catherine Tan Md Pllc | |
|
300 White Spruce Blvd Suite 100 Rochester NY 14623-1606 | |
| (585) 424-7000 | |
| (585) 427-2712 |
| Full Name | Catherine Tan Md Pllc |
|---|---|
| Speciality | Internal Medicine |
| Location | 300 White Spruce Blvd, Rochester, New York |
| Authorized Official Name and Position | Catherine Chiu Tan (SOLE MEMBER) |
| Authorized Official Contact | 5854247000 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Catherine Tan Md Pllc 300 White Spruce Blvd Suite 100 Rochester NY 14623-1606 Ph: (585) 424-7000 | Catherine Tan Md Pllc 300 White Spruce Blvd Suite 100 Rochester NY 14623-1606 Ph: (585) 424-7000 |
| NPI Number | 1477873966 |
|---|---|
| Provider Enumeration Date | 06/07/2010 |
| Last Update Date | 10/09/2022 |
| Medicare PECOS PAC ID | 8820286339 |
|---|---|
| Medicare Enrollment ID | O20101228000871 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1477873966 | NPI | - | NPPES |
| 1880148 | Medicaid | NY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 201582 (New York) | Primary |
| Provider Name | Catherine C Tan |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1508886219 PECOS PAC ID: 9638363211 Enrollment ID: I20101027001057 |
| Provider Name | Pamela J Damiani |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1346413416 PECOS PAC ID: 8527243278 Enrollment ID: I20110425000342 |
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